Evaluation of an Internet diabetes self-management training program for adolescents and young adults

Background: There are inadequate information and support resources available for adolescents and young adults with diabetes. This article describes the pilot phase of an Internet program to assist these individuals who are transitioning to adult-centered medical care. Methods: We developed an online program consisting of background information on diabetes, goal-setting exercises with individualized feedback, role-playing, group discussions, empowerment activities, and communication skills training designed to improve interactions with health professionals. We provided low-income participants enrolled in the study with recycled desktop computers and dial-up Internet service. They also received encouragement and computer use reminders from a diabetes educator. During a 6-month intervention period, we monitored participant utilization of the Internet program. Results: We recruited a convenience sample of 19 young adults with diabetes from the Chicago Childhood Diabetes Registry, as well as from two inner-city clinics. Participants accessed the program 4,445 times, with the discussion board receiving the greatest activity (2,256 total posted and read messages). Participants used the program most frequently at night, with an overall gradual decline in computer use over the 6-month period. To help maintain utilization, the diabetes educator placed a total of 439 telephone calls over 6 months (15-38 calls per participant). Conclusions: The study demonstrated feasibility of using an Internet program to meet the informational and social needs of adolescents and young adults with diabetes. Participant involvement relied heavily upon reminders and encouragement from a diabetes educator and immediate family members.